CHICAGO (AP) — Peering through the chain link of a holding pen at the Cook County Jail, a man wrapped in a navy varsity jacket leans toward clinical social worker Elli Petacque Montgomery, his bulging eyes a clue that something's not right.
"They say I got bipolar, that's all," he says.
"OK, are you taking your meds?" she asks.
"When I can get them," he answers.
"I'm down here every day," Montgomery says. "Every morning I hear this."
The Chicago jail and many of its 3,300 counterparts across the country have become treatment centers of last resort for people with serious mental illnesses, most arrested for non-violent crimes. And like other jails, it is awash in a tide of booking and releases that make it particularly unsuited for the task.
U.S. jails, most of whose 731,000 inmates are trying to make bail or awaiting trial, hold roughly half the number in prisons. But last year, jails booked in 11.7 million people — 19 times the number of new prison inmates. The revolving door complicates the task of screening for mental illness, managing medications, providing care and ensuring inmate safety.
"Jails are churning people," says Henry J. Steadman, a consultant to government agencies on how courts and correctional facilities deal with people with mental illnesses.
Experts have pointed to rising numbers of inmates with mental illnesses since the 1970s, after states began closing psychiatric hospitals without following through on promises to create and sustain comprehensive community treatment programs.
But as the number of those with serious mental illnesses surpasses 20 percent in some jails, many have struggled to keep up, sometimes putting inmates in jeopardy.
The Associated Press has reported that at least nine of the 11 suicides in New York City jails over the past five years came after operators failed to follow safeguards designed to prevent self-harm by inmates. The AP's investigation into the deaths of two mentally ill inmates at the city's Rikers Island complex — one who essentially baked to death in a 101-degree cell in February and the other who sexually mutilated himself last fall — have prompted promises of reform.